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Neal Patterson, co-founder, CEO and chairman of health IT heavyweight Cerner, died today at the age of 67. According to the company, Patterson had “unexpected complications” from a recurrence of the soft-tissue cancer that caused him to take a yearlong leave starting in January 2016.

As the “unexpected” explanation suggests, the news comes as a bit of a surprise, since Patterson returned to work early this year. He had made a surprise appearance at the Cerner annual users’ meeting in November.

In another unexpected development, the North Kansas City, Missouri-based EHR vendor named Co-founder and Vice Chairman Cliff Illig to serve as chairman and interim CEO. During Patterson’s leave, President Zane Burke was the public face of the company. Burke gave me a long interview at CHIME last fall.

However, Cerner said in a statement that there has been a “longstanding succession plan” and that “the process to select a new CEO is nearing a conclusion,” suggesting that Patterson had intended to step down fairly soon.

“One of Neal’s enduring ambitions for Cerner was to build a visionary company, not just a company with a visionary,” Illig said in the statement. “He has done that. We have what I believe is the best management team in health IT, and we have associates who think as much about the future as they do the present. As a result, Cerner is well-positioned to have a pioneering impact on the provision of health care in the years to come.”

Patterson, Illig and Paul Gorup founded Cerner as PGI & Associates in 1979 to develop laboratory information systems. They changed the name to Cerner in 1984 and took the company public in 1986.

Lawrence L. Weed, M.D., a pioneer in the world of health informatics and organization of patient information, has died at the age of 93. Weed passed away in Burlington, Vermont, on June 3 after a fall two weeks earlier, his son Lincoln said.

Weed created the who created the problem-oriented medical record (POMR) and the subjective, objective, assessment, planning (SOAP) format of progress notes that became ubiquitous. He had advocated for what now is known as clinical decision support for at least 60 years, talking often about “coupling” patient problem lists with medical knowledge that changes often.

“The unaided mind does not know what data to collect, and does not see many of the significant relationships buried in whatever data are collected,” Weed said in a 2004 story I wrote for Health-IT World, a former spinoff of Bio-IT World. Thus, according to Weed, paper records were inferior to computerization — and they were half a century ago.

While at the University of Vermont in 1976, Weed co-developed an early electronic medical record called the Problem-Oriented Medical Information System, or PROMIS.

In a seminal 1968 article in the New England Journal of Medicine, Weed wrote:

Since a complete and accurate list of problems should play a central part in the understanding of and management of individual patients and groups of patients, storage of this portion of the medical record in the computer should receive high priority to give immediate access to the list of problems for care of the individual patient and for statistical study on groups of patients.”

To this end, Weed developed a system of “problem-knowledge couplers,” and founded PKC Corp. in 1982 to market his idea. The company landed a series of government contracts, but struggled to catch on in the public sector. Weed was forced out by investors in 2006, and PKC was sold to consumer health company Sharecare — founded by WebMD founder Jeff Arnold and TV doctor Mehmet Oz, M.D. — in 2012.

Weed described the framework of problem-knowledge couplers in a 1994 article in the journal Medical Interface.

A true Renaissance man fond of quoting Francis Bacon, Tolstoy, Copernicus, Galileo and other celebrated philosophers, Weed was known as a brilliant educator, deep thinker and an engaging speaker. At the age of 89, he commanded the stage for a good 75 minutes at the HIMSS13 Physicians’ IT Symposium, and received two standing ovations.

“The worst, the most corrupting of all lies is to misstate the problem. Patients get run off into the most unbelievable, expensive procedures … and they’re not even on the right problem,” Weed said during that memorable presentation in New Orleans.

“We all live in our own little cave. We see the world out of our own little cave, and no two of us see it the same way,” he continued, explaining the wide deviation from standards of care. “What you see is a function of who you are.”

Lincoln Weed lamented that health IT companies have not always paid attention to these ideas. “The informatics community hasn’t really caught up to my father’s work,” the son said. “It’s not about technology. It’s about standards of care.”

The problem-oriented medical record is a standard for organizing information in a record. Couplers are standards for collecting data to generate recommendations based on the ever-changing body of medical knowledge, according to Lincoln Weed.

Some of Larry Weed’s ideas did catch on, notably, the SOAP note. However, some have recently rethought that format for the digital age, swapping the first two and last two element to create the APSO note. Weed defended his approach in 2014.

Weed stayed active up until his last day alive, according to Lincoln Weed. The day Larry Weed died, he discussed a poorly adopted National Library of Medicine personal health records project with sons Lincoln and Christopher. Lincoln recalled that his father said the NLM tool needs to let patients enter their own health data.

“I’m hopeful that the NLM is close to jumpstarting that process,” Lincoln Weed said. “Dad died with more optimism than he had had in a long time.”

Lincoln Weed said that the late Tom Ferguson, M.D., who founded the journal Patient Self-Care in 1976, “thought Dad was one of the originators” of the empowered patient movement.

With patient-generated data and now genomic information making its way into clinical practice, a system for organizing medical records is more necessary than ever, Lincoln Weed said. Equally important, he said, is a computerized system for matching the patient problem list with all known, relevant information to address specific problems — couplers.

“I’m glad Dad has left me with these things to work on,” said Lincoln Weed, a retired attorney who co-authored “Medicine In Denial” with his father in 2011.

Weed, who earned his medical degree from Columbia University in 1947, is survived by five children, a sister, two grandchildren and two step-grandchildren, according to the Burlington (Vermont) Free Press. He was preceded in death by his wife, Laura, a physician herself who died in 1997.

Weed’s public memorial will focus on his lifelong love of classical music. His children are planning a memorial concert on Sept. 17 at 4 p.m. Eastern time at Charlotte Congregational Church, 403 Church Hill Rd, Charlotte, Vermont, according to the Burlington Free Press.

Here is a video of Weed from a well-known grand rounds he presented in 1971. It was unearthed by a Weed disciple, Art Papier, M.D., of clinical decision support vendor VisualDx.

Attention, kind readers. After years of doing this blog in fits and starts — particularly the two-year gap while I was essentially prohibited by a full-time employer from writing about health IT here or anywhere else but that company’s site — I have decided to refocus on healthcare consumers rather than industry insiders.

The “Meaningful HIT News” name itself has become dated, given that the Meaningful Use program from which this blog takes its name has evolved and kind of fallen out of favor. For those not up on the lingo, “meaningful use” is the standard healthcare providers must meet to qualify for Medicare and Medicaid bonus payments for use of health information technology and/or avoid penalties for not being “meaningful” users of electronic health records.

The program came about in 2009 with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, a bipartisan part of the very partisan American Recovery and Reinvestment Act (ARRA); ARRA was President Barack Obama’s $831 billion stimulus legislation. Despite what you may have read elsewhere, Meaningful Use was not part of the Patient Protection and Affordable Care Act, the 2010 bill that’s come to be known as Obamacare.

Meaningful Use was largely successful in getting hospitals and physician practices to adopt electronic health records, which was the goal of Stage 1 (2011-13, give or take). But it started to fall apart in Stage 2 (2014-16), which required participants to share data with other healthcare organizations. Now we have reached Stage 3, in which hospitals and doctors are supposed to prove that they are able to provide better, safer, less costly care with the help of their electronic records.

While all this was happening, Congress got impatient about the $35 billion in incentive money that has been distributed to date and passed legislation at the end of 2015 that changed how physicians are paid for treating Medicare patients. Long story short, Meaningful Use Stage 3, at least for doctors and other individual practitioners, is now part of a bigger calculation that pays for outcomes rather than for simply providing more services. The Meaningful Use program remains unchanged for hospitals.

I won’t bore you with any more details, but I think it’s time to look at the bigger picture, namely the rights and responsibilities patients have in making their own care better. Stay tuned for real patient stories and advice in the next few days. In the meantime, check out the post that represented a shift in my thinking, after my dad passed away nearly five years ago.

I want to help you become empowered patients. That, to me, is what is really meaningful.

I’ll categorize every relevant post as “The Patient Journey” so you can find these stories in the future.

After several years of trying, John Lynn — host of the Healthcare Scene blog network, of which this blog is a part — has finally gotten me to speak on a panel at his Health IT Marketing and PR Conference, April 5-7 in Las Vegas. I’ve had schedule conflicts or disinterested bosses in the past, but now that I’m mostly unemployed, hey, let’s do it!

I will be on the panel entitled, “The Best Ways to Interact with the Health IT Press,” along with some familiar names: Author and freelance journalist Dan Munro; Scott Mace of H3.Group, publisher of HealthLeaders, DecisionHealth, HCPro, Patient Safety & Quality Healthcare and ACDIS; conference host John Lynn; and session moderator Shahid “The Healthcare IT Guy” Shah. The panel takes place April 6 at 1:30 p.m. PDT at the SLS Las Vegas, which I’m told is far nicer than the hotel it replaced on the south end of the Strip, the Sahara.

Some of you PR and marketing types might find this ironic because I’m notoriously prickly when it comes to dealing with some of you, particularly in the weeks leading up to HIMSS each year. I can’t speak for the other panelists, but I’m hoping that this discussion can help shed some light on how I think when dealing with a seemingly endless flow of pitches, how journalists and publicists can make best use of each other’s time and how we can forge better working relationships.

I haven’t decided exactly what I’m going to say yet because I’m still mostly flying by the seat of my pants, having lost my full-time job less than three weeks ago.

(Yes, I’m still looking for something full-time, but accepting freelance gigs for now, with a major caveat: I can’t take one-off gigs for vendors or anyone else I might cover because that creates conflicts of interest with other work I do. Here’s an idea of what I’m thinking. And while you’re at it, go read my posts at Forbes.com because I get paid by the click. So does Munro, another Forbes contributor.)

It will be a quick trip to Vegas, less than 24 hours on the ground, but it should be worthwhile. I hope to see you there.

I did a video interview this week with AliveCor COO Doug Biehn about that company’s launch today of a physician-side artificial intelligence platform for mining ECG readings for signs of atrial fibrillation, a key early marker of stroke risk. AliveCor also announced it has closed a $30 million Series D investment round, led by Omron Healthcare and Mayo Clinic.

I goofed in one spot as I was editing the video after midnight: I was in Chicago, not Silicon Valley, as you might be able to tell from the artwork behind me. The error is sorta fixed if you’re watching on a desktop computer, but YouTube annotations don’t show up on mobile devices. (In fact, YouTube is phasing out video annotations this month for that very reason.)

Remember the “death panels” hysteria in 2009 or so when the Affordable Care Act was under development? (PolitiFact called “death panels” the “lie of the year” for 2009, not surprising, since the idea apparently originated with that truth stretcher extraordinaire, former Alaska Gov. Sarah Palin.)

As you may have heard, that rhetoric resurfaced during town halls held by a few Republican members of Congress.

That idiocy came from language in the ACA that authorized Medicare to pay for voluntary end-of-life counseling. It was falsely projected as a “mandatory” activity every five years.

Some of the hysteria also stemmed from a specific clause in the ACA that said:

Establishes an Independent Payment Advisory Board to develop and submit detailed proposals to reduce the per capita rate of growth in Medicare spending to the President for Congress to consider. Establishes a consumer advisory council to advise the Board on the impact of payment policies under this title on consumers.

The fear, from the right-wing punditry was that bureaucrats would start to deny care to older, sicker Americans.

Other ACA provisions related to Medicare are not changed, including:
* Increase Medicare premiums (Parts B and D) for higher income beneficiaries (those with incomes above $85,000/individual and $170,000/couple).
* Authorize an Independent Payment Advisory Board to recommend ways to reduce Medicare spending if the rate of growth in Medicare spending exceeds a target growth rate.
* Establish various quality, payment and delivery system changes, including a new Center for Medicare and Medicaid Innovation to test, evaluate, and expand methods to control costs and promote quality of care; Medicare Shared Savings Accountable Care Organizations; and penalty programs for hospital readmissions and hospital-acquired conditions.

So, is the GOP plan embracing death panels, or is Republican leadership simply admitting that they were lying all along to whip up paranoia?

Here’s the easiest prediction I will make this week: Dr, Andrey Ostrovsky, chief medical officer of the Center for Medicaid and CHIP Services, is about to lose his job after just six months.

How do I know this? Ostrovsky isn’t just privately opposed to the American Health Care Act — the newly released Republican “repeal and replace” of the Affordable Care Act. He tweeted his opposition to the bill yesterday.

And he made the likely fatal mistake of citing outside opinions that don’t square with those of the Trump administration. Indeed, the American Medical Association, American Academy of Family Physicians and American Academy of Pediatrics have all come out against the first iteration of the AHCA.

We know that President Donald Trump pays attention to what gets said on Twitter. We also know what the Trump White House thinks of dissension within the ranks. Ask longtime U.S. Department of Justice attorney Sally Yates about that.

And she wasn’t just fired. The administration questioned her patriotism by saying Yates “betrayed the Department of Justice by refusing to enforce a legal order designed to protect the citizens of the United States.”

Expect Ostrovsky to lose his job soon, in no small part because his tweet has so many likes and retweets. Perhaps it was a calculated move on his part?

This isn’t exactly breaking news — that happened in the craziness of HIMSS17 a couple of weeks ago — but I am now a member of The Walking Gallery of Healthcare. The Walking Gallery is a series of paintings on jackets, mostly, but not completely, created by artist/patient advocate Regina Holliday, meant to spark conversations about healthcare.

Each painting depicts a difficult healthcare situation that the wearer or a loved one of the wearer experienced. In my case, it is the story of my late father’s terrible experience in a poorly run community hospital as he was dying of a rare disease called multiple system atrophy, and my own advocacy as a result of his ordeal.

Holliday calls this one, “Miles to Go Before I Sleep,” likely because I undertook a bike tour from Chicago to Washington, D.C., in 2014 in my dad’s memory, and, likely, because I am a notorious night owl/occasional insomnia sufferer. I think there’s also some meaning in the fact that I have been a restless advocate, via my writing, for better care since I had to witness his suffering nearly five years ago. (I didn’t get to see a draft of the painting until I received my jacket, which is only fair, since as a rule, I don’t let story subjects see copies of my work prior to publication.)

The painting of me as a child is based on this photo of me as a baby. My dad didn’t have a mustache for long, but he did when I was a toddler.

To this day, my mother will tell you I was the most beautiful baby she ever saw. That’s a completely objective statement because she has no inherent bias at all.

I didn’t know what to expect, but I absolutely love the final result of the painting, which includes purple, the color of MSA awareness, at least in North America. The jacket itself cost a whopping $50 at Marshall’s because I wasn’t sure if people sent expensive or cheap sportcoats to be painted.

Did you see the news yesterday about the ransomware attack against Emory Healthcare in Atlanta?

According to Health Data Management, a hacker breached the appointment scheduling system at the Emory Clinic’s Orthopedics and Spine Center and the Brain Health Center, and demanded an unspecified ransom. The breach affected 79,930 patients.

Emory Healthcare said it learned of the hack on Jan. 3, and the organization submitted a breach report to the HHS Office for Civil Rights on Feb. 21.

But that’s all the organization said, and for good reason. It’s the same reason why MedStar Health in the Washington-Baltimore areas has not spoken to the press about its ransomware attack last March and April.

At a preconference symposium before last week’s HIMSS conference in Orlando, Florida, a security expert told attendees that the FBI instructs health systems not to talk publicly about such attacks, or disclose whether they have paid ransom. Hollywood Presbyterian Medical Center in Los Angeles did confirm that it paid about $17,000 ransom a year ago, but as I wrote at the time, the hospital doesn’t seem to have much of a clue about a lot of things, including patient safety and public ratings.

But if you’re wondering why you haven’t heard much follow-up from hacked hospitals, it’s likely because of the FBI, which doesn’t much like to compromise criminal investigations.

Hey there, it’s been a long time since I’ve blogged here. I will be doing more of it in the near future because I’ve just been unceremoniously let go from my day job in the immediate aftermath of me owning HIMSS coverage again and having the top two stories on the site on Monday and the top story on Tuesday. Their loss.

That means I will be posting daily in the short term, but it also means I’m looking for work. Here’s a link to my résumé, in case you know of any suitable opportunities.

I am thinking maybe my career in daily/weekly journalism has run its course after 25 years, including the last 16 in healthcare. I’m open to opportunities in research (after all, I have a history degree), analysis or maybe even consulting. I’d like to write books, but I have no real means of supporting myself while doing so.

If you have any ideas, contact me at nversel@gmail.com. I will say that I am not interested in freelance marketing gigs for specific vendors, because those would create conflicts of interest whenever I cover competitors. (If you have something full-time, let’s talk.)

In the meantime, enjoy the new posts on Meaningful HIT News (though the name is kinda dated now).

Free Healthcare IT Newsletter Want to receive the latest news on EMR, Meaningful Use,
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